NEUROLOGY MULTIPLE CHOICE QUESTIONS (2)

 1. Which one is not a clinical presentation in Guillain Barre Syndrome?

Ascending paralysis

Weakness and paresthesias

Descending paralysis

Autonomic dysregulation

- C

2. CSF with an increased level of proteins +/- pleocytosis, and diffuse demyelination in nerve conduction studies are seen in:

Multiple Sclerosis

Amyotrophic Lateral Sclerosis

Myasthenia Gravis

Guillain-Barre Syndrome

- D

3. 40 yo man comes to the ED with progressive weakness and paresthesias in his legs, later in his arms over the last few days. In the Physical Exam is seen: SO2 90% (FiO2 21%), slightly dyspneic, lungs clear to auscultation bilaterally, Strength 3/5 in LE bilateral, 4/5 UE bilateral, areflexia in LE bilateral. The patient refers to an episode of diarrhea 3 weeks ago. What is the best initial step?:

IVIG infusion

Plasmapheresis

O2+ monitor Peak Inspiratory Pressure and Vital capacity 

Nerve conduction studies

- C

4. 60 yo man presents with progressive swallowing impairment over the last 15 days, associated with weight loss.  Also refers to weakness in his right hand later in his left hand that appeared 2 months ago. Denies pain, fever, night sweats, changes in bowel movements, urinary incontinence, paresthesias, tingling. PE fasciculations in tongue, weakness in UE and LE bilateral, atrophy in LE bilateral, Babinski + bilateral. Which of the following delay disease progression?

CPAP

Steroids

Plasmapheresis

Riluzole

- D

5. In the previous case, this medical condition is characterized for the following, except:

It is a progressive degenerative disease of both upper and lower motor neurons.

Associated with recent Campylobacter jejuni infection.

Paresthesias and autonomic dysregulation

B and C

- D

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